Craniofacial surgery is a term used to describe surgery involving the bones of the face and skull (craniofacial skeleton), as well as the soft tissue of the face. This type of surgery requires skill and precision, particularly in procedures that involve reconstructing a patient's facial features. In such procedures, a slight miscalculation can result in an unacceptable facial asymmetry and require complex corrective surgery.
Craniofacial surgeons must therefore attempt to predict how a patient will heal and, in a pediatric patient, grow, and tailor their surgical techniques accordingly. This can be difficult, particularly in cases involving movement of underlying bone. More specifically, as might be expected, movement of underlying bone will cause overlying soft tissue (e.g., skin) also to move. Post-surgical conditions such as swelling and scarring can affect that movement. In time, these conditions resolve, and the soft tissue settles or re-drapes into its final position. However, resolution of post-surgical conditions varies for different patients, and is dependent on a number of factors. As a result, the soft tissue may not settle or re-drape as predicted.
In addition to the foregoing post-surgical conditions, other factors can affect movement of the soft tissue. For example, patients with taut skin, such as younger patients and those who have had previous surgery, are likely to exhibit more pronounced soft tissue movement, whereas patients with loose skin, such as the elderly, are likely to exhibit less pronounced soft tissue movement. Similarly, patients with relatively thick skin, excessive pre-existing scarring, and skin conditions, such as scleroderma, will exhibit soft tissue movement that is dependent, at least in part, on their skin type and/or skin condition. These factors can also increase the difficultly of predicting the final position of soft tissue following craniofacial surgery.